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  • Interpretation
  • No.404【Under Translation】
  • Date
  • 1996/05/24
  • Issue
    • Does a disciplinary action under Article 25 of the Physician Act taken against a Chinese herbal doctor who does not have a medical doctor’s license but treats patients with prescription drugs violate the right of work guaranteed by Article 15 of the Constitution, thus being null and void?
  • Holding
    •        Article 15 of the Constitution provides that the people*s right of work should be protected so that people can freely choose their work and professions to maintain their livelihood. Because people*s work is closely related to the public welfare, and is necessary to improve the public interest, work engaged in and qualifications or other requirements possessed by people should be properly restricted by law. This is evident in Article 23 of the Constitution. To strengthen specialization and task sharing, protect patients’ rights and improve the nationals’ health, the Physician’s Act provides for three categories of physicians- doctors, Chinese herbal doctors, and dentists-so that physicians from different areas of medicine can provide medical services to patients in accordance with their medical specialties. Article 41 of the Medical Service Act provides that physicians who are in charge of a medical institution should supervise the institution*s medical personnel in the performance of medical services in accordance with the specific law governing their areas of medicine. Both regulations are necessary to improve the public interest. Chinese herbal doctors should provide treatments according to traditional Chinese medical methods. If a Chinese herbal doctor does not have a medical doctor’s license but treats patients with prescription drugs or over-the-counter medicines, he obviously is not providing medical treatment according to traditional Chinese medical methods, and thus violates the principle of specialization and task sharing and the trust patients have in him. Directive No. 370167 issued by the Department of Health in the Executive Yuan stated: “(3) If a Chinese herbal doctor without a medical doctor’s license treats patients with prescription drugs, it is deemed to be improper conduct within the scope of medical service, and he thus should be disciplined based upon Article 25 of the Physician Act. (4) Pursuant to the Drugs and Pharmacists Management Act (now the Pharmaceutical Affairs Act), over-the-counter medicines can be dispensed for the treatment of illness by those without a physician’s license. Therefore, the dispensing of over-the-counter medicines for patients is not within the scope of a Chinese herbal doctor*s medical service.” The interpretation of a Chinese herbal doctor*s scope of medical service provided by the Department of Health in the Executive Yuan complies with the legislative intent of the Physician Act and the Medical Service Act, and is consistent with the right of work guaranteed by the Constitution.
  • Reasoning
    •        Article 15 of the Constitution provides that the right of work of the people should be protected so that people can freely choose their work and professions to maintain their livelihood. Because people*s work is closely related to the public welfare, and is necessary to improve the public interest, thus Article 23 of the Constitution explicitly provides that work engaged in and qualifications or other requirements possessed by people should be properly restricted by law. Medical doctors provide medical services for the purpose of maintaining patients’ lives and health. To strengthen specialization and task sharing, protect patients’ rights and improve the nationals’ health, the Physician Act provides for three categories of physicians- doctors, Chinese herbal doctors, and dentists-so that physicians from different areas of medicine can provide medical services to patients in accordance with their medical specialties. Under the Physician Act, respective qualifications for doctors, Chinese herbal doctors, and dentists are different. Article 41 of the Medical Service Act also provides that physicians who are in charge of a medical institution should supervise the institution*s medical personnel in the performance of medical services in accordance with the specific law governing their areas of medicine. Both regulations are necessary to improve the public interest. To merit patients’ trust, Chinese herbal doctors should provide treatments according to traditional Chinese medical methods. If a Chinese herbal doctor, who also has a medical doctor*s license, in the treatment of a disease or illness, applies methods of western medicine and traditional Chinese medicine, it is within the scope of his expertise and is thus a proper conduct of medical service. It is clearly evident by Article 3, Paragraph 1, Subparagraph 2, of the Physician Act which provides that a person who has graduated from a medical school, and has taken required courses in Chinese medicine, and has passed the Chinese herbal doctor*s qualification exam, is a person who possesses both a medical doctor*s and Chinese herbal doctor*s licenses. Except for the abovementioned situation, if a Chinese herbal doctor treats patients with prescription drugs, or over-the-counter medicines which should not be given to patients by those without a medical doctor*s license, he violates the principle of specialization and task sharing and the trust patients have in him for treatments in accordance with traditional Chinese medical methods. This restriction is applicable to a Chinese herbal doctor who also has a pharmacist*s license. Article 15 of the Pharmacist Act states: "Services provided by pharmacists are: (1) sales or administration of pharmaceutical products, (2) prescription and preparation of pharmaceutical products, (3) appraisal of pharmaceutical products, (4) supervision of the manufacture of pharmaceutical products, (5) supervision of the storage, supply, and packaging of pharmaceutical products, (6) supervision of the manufacture of cosmetics containing medicine, and (7) those which should be performed by pharmacists under the law." Therefore, a pharmacist should not treat patients with pharmaceutical products he himself prescribes. As to some prescription drugs which should not be given to patients by those without a medical doctor*s license, the "doctor" therein does not include the Chinese herbal doctor. Thus, Chinese herbal doctors should not treat patients with prescription drugs. In addition, Article 9 of the Pharmaceutical Affairs Act provides that over-the-counter medicines should be processed and produced from raw herbs. However, the original names of the raw herbs should not be used for labeling purposes. Below restrictive amount of anesthetic or poison regulated by the central health authority is added to over-the-counter medicines. Thus, their treatment effects are mild and without residue. They can be stored for a long period of time and are easy to use. Their treatment effects, dosage, usage, and permit numbers should all be clearly labeled. They can be taken by patients to treat diseases/illnesses without the requirement of a medical doctor*s prescription. If a Chinese herbal doctor treats patients with over-the-counter medicines, he obviously does not treat patients with traditional Chinese medical methods. Directive No. 370167 issued by the Department of Health in the Executive Yuan stated: “(3) If a Chinese herbal doctor without a medical doctor’s license treats patients with prescription drugs, his conduct is deemed to be improper within the scope of medical service, and he thus should be disciplined under Article 25 of the Physician Act. (4) Pursuant to the Drugs and Pharmacists Management Act (now the Pharmaceutical Affairs Act), over-the-counter medicines can be used to treat illnesses without the requirement of a medical doctor*s prescription. Therefore, treating patients with over-the-counter medicines is not within the scope of a Chinese herbal doctor*s medical service.” The interpretation of a Chinese herbal doctor*s scope of medical service provided by the Department of Health in the Executive Yuan complies with the legislative intent of the Physician Act and the Medical Service Act, and is consistent with the right of work guaranteed by the Constitution. 
      
    • *Translated by Li-Chih Lin, Esq., J.D.
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